Subcutaneous Heparin In Prevention Of Disseminated Intravascular Coagulation In Patients With Serious Infections

In a series of 21 patients with serious Gram-negative and Gram-positive infections, 5000u. heparin was admini- stred subcutaneously 12-hourly with the aim of reducing the incidence of disseminated intravascular coagulation.

Before starting heparin therapy there were prolongation of partial thromboplastin time; moderately increased levels of fibrinogen degradation products (FDP); decreased antithranbin III (AT III) activity (measured with chromogenic substrates); and positive paracoagulaticn tests.

On heparin therapy FDP decreased and platelet count and AT III increased; and there were no clinical or laboratory signs of DIC. In those who died there were no postmortem signs of intravascular fibrin deposition.

19 of the 21 patients developed septic shock. These received standard therapy as well as subcutaneous heparin. 14 patients (66%) died. There were no complicaticns with heparin therapy.

In serious infections prophylactic subcutaneous heparin is advisable as early as possible.